HomeMy WebLinkAboutBldg Permit 05-0689
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
7-/~ (>
I White
Pink
3 Yellow
File
City
Applicant
I PERMIT NO. 0 So' 0619
(Please type or print and sign at bottom)
ADDRESS
//...5 ~ S ..5dA-//, [y ~'-/L
/
ZONING (office use)
LEGAL DESCRIPTION (office use only)
,
LOT
BLOCK
ADDITION
PID
OWNER 7'") :/L (
(Name)~PV~ /T""':::</ /1/~r.A---
(Address) .$ A-A"1L
(Phone)
?6~-j?3-/8':Z~'-
BUILDER ~ ' / ~ /'
(Company Name)----Pv-"'/ - /C~/L_ ~t:lr'/ A/~
(Contact Name) ---PA,-,1-/ ,.q.~4J"'~~~
(Address) ~IJ' X"'? p,~~A-- ~~"." ~ /
~ , (Phone) 7S-..:2 -~ ~/,- q S-r
(Phone) ~ -.$7:'/ - 3' ~ ~ ~
//~t.?~ .fCt:9-2C/ , -
TYPE OF WORK 0 New Construction ODeck o Porch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtiIity Connection
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
o Misc.
I
E
II
F
1
III IV V
HIM
234
A
R
5
B
S U
PROJECT COST IV ALUE $
(excluding land)
x
lication which is to the best of my knowledge true and correct. I also certtfY that I am the owner or authorized agent for the
conform to all eXlsl1ng state and local laws and will proceed in accordance with submittcd plans. I am aware that the building
more, I hereby agree that the cay official or a designee may enter upon the property to perform needed inspectIOns
~ ~/9~~
Signature
Contractor's License No. Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ '7&,~U u
"
Paid 7(0" (/V Receipt DoJ'o. ~J/Y
Date 2/~~- By A_
U
I Permit Valuation
I Permit Fee $
I Plan Check Fee $
I State Surcharge $
I Penalty $
I Plumbing Permit Fee $
I Mechanical Permit Fee $
I Sewer & Water Permit Fee $
I Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Building Otlicial
Date
ThIS tS to certifY that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner conSl1tutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate llf Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
7k~r
",
ADDRESS /K5I!;'s- ~/r-t:-Y
OWNER CONTR.
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
COMMENTS:
,/2 I
?;~. ~/;.C'S.
. ~ .::..2Cr-
/
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINA/L
o "H FINAL
/~eroC)
0~~
~P&?
7L
~---<-
00-- 6 ~
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/-t:?~ C
-/ J_
/ <..-C. ~
.~ /7 /
/~ r- q,l/~/S CJK /
;;OP, <~~ ---:z..r",<./~cI
--=::--, )
~<U e /~ ),.,
~KSATIS ,.elW,PROCili~ ~
~-
,/ 0 CORRECT ACT/ON AND PROCEED
Inspector:
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~
-"
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSlVon